OLEG ANTONOV (NPI# 1841481561) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841481561 |
| Entity Type | Individual |
| Full Name | OLEG ANTONOV |
| Credential | MD |
| Practice Address |
11400 Bustleton Ave Philadelphia PA 19116-2815 |
| Practice Telephone | 2677881424 |
| Mailing Telephone | 2677881424 |
| Mailing Fax Number | 2153649726 |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2014-09-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
MD432473 | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | LICENSE | MD432473 | 01 |
| Street Address |
11400 BUSTLETON AVE |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19116-2815 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275571945 | Oleg Volchonok | Internal Medicine | 11400 Bustleton Ave, Philadelphia, PA 19116-2815 | 2006-06-03 |
| 1710307087 | Oleg Antonov Md PC | Dermatology | 11400 Bustleton Ave, Philadelphia, PA 19116-2815 | 2014-04-24 |
| 1396186201 | Oleg Antonov Md PC | Specialist | 11400 Bustleton Ave, Philadelphia, PA 19116 | 2013-07-09 |
| 1780962795 | Rds Rehabilitation Associates, P.C. | Specialist | 11400 Bustleton Ave, Philadelphia, PA 19116-2815 | 2011-07-25 |
| 1790951390 | Oleg Volchonok, Md, PC | Internal Medicine | 11400 Bustleton Ave, Philadelphia, PA 19116-2815 | 2008-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194334466 | Ambassador Home Care Services LLC | Homemaker | 118080 Bustleton Av, Suite 301, Philadelphia, PA 19116 | 2020-07-23 |
| 1669919445 | Lenore Pierce Bailey | Social Worker | 15100 Dahlia Drive, Philadelphia, PA 19116 | 2017-01-31 |
| 1477938991 | Jessica Gabriela Dashevsky | Counselor | 467 Parlin St, Philadelphia, PA 19116 | 2015-07-27 |
| 1174949697 | Absolute Therapy Care LLC | Physical Therapist | 10125 Verree Rd Ste 100, Philadelphia, PA 19116 | 2014-03-07 |
| 1790107936 | Philmont Homecare, LLC | Home Health | 14500 Bustleton Avenue, Suite 208, Philadelphia, PA 19116 | 2014-01-07 |
| 1417381609 | Able Ambulance Inc. | Ambulance | 1017 Haldeman Ave., Philadelphia, PA 19116 | 2013-08-25 |
| 1821356718 | Timur Kakhramanov | Nurse Practitioner | 301 W.byberry Rd, Unit F-6, Philadelphia, PA 19116 | 2012-04-27 |
| 1982975173 | Simon Perelshteyn | Internal Medicine | 10172 Verree Rd, Philadelphia, PA 19116 | 2012-01-19 |
| 1841574449 | Irene Feldman | Pharmacist | 10000 Busteloton Ave, Philadelphia, PA 19116 | 2011-10-03 |
| 1992095590 | Long Life Ambulance, LLC | Ambulance | 10065 Sandmeyer Lane, 103, Philadelphia, PA 19116 | 2011-04-15 |
| Find all providers in zip 19116 | ||||
| Taxonomy Code | 207QA0505X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adult Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972036515 | Hussein Safa | Family Medicine | 1300 W Tabor Rd Bldg 1, Philadelphia, PA 19141 | 2017-04-11 |
| 1538433040 | Ramona Chube, M.d.,p.c. | Family Medicine | 7700-a Stenton Ave, Philadelphia, PA 19118-3103 | 2012-03-01 |
| 1124264809 | Michael A Oriente | Family Medicine | 1901 Fairmount Avenue, Philadelphia, PA 19130 | 2008-12-30 |
| 1699979161 | 7622 Medical Center Dba 1900 S.g. Associates | Family Medicine | 2000 Spring Garden St, Philadelphia, PA 19130-3805 | 2007-06-11 |
| 1861558314 | Lewis Meyer Jacobs | Family Medicine | 1408 N 17th St, Philadelphia, PA 19121-4207 | 2006-12-29 |
| 1841359148 | Arthur K Smith | Family Medicine | 535 Pine St, Philadelphia, PA 19106-4110 | 2006-12-06 |
| 1770650970 | Agnes H Simmons | Family Medicine | 6201 Chestnut St, Philadelphia, PA 19139-2906 | 2006-11-30 |
| 1336226166 | Mark Thomas Watkins | Family Medicine | 253 So 10th Street, Suite 201, Philadelphia, PA 19107-5605 | 2006-11-01 |
| 1639124639 | Zhanna Vladimirovna Galperin | Family Medicine | 1822 Benton Avenue, Philadelphia, PA 19152-1099 | 2006-05-24 |
| 1194777466 | Peter Rex Honig | Family Medicine | 1805 S Broad St, Philadelphia, PA 19148-2115 | 2006-05-16 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19116 |
Please comment or provide details below to improve the information on OLEG ANTONOV.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.